Chronic Disease is the term used when course of the illness lasts for more than three months.

Chronic disease is the term used when course of the illness lasts for more than three months. Chronic diseases that are most common include the following. Many chronic diseases have genetic components which increases disease risk in certain people. Environment and exposure to polluted air, lifestyle choices including diet and smoking may affect the outcome of chronic disease.

Chronic diseases that are most common, include the following.


Arthritis is defined as painful swelling one or more joints. Main symptom is pain and stiffness. Most common arthritis are osteoarthritis and rheumatoid arthritis. Current treatment recommendation is nonsteroidal anti-inflammatory drug, NSAIDs reduce both pain and inflammation ibuprofen or naproxen may help as well. Other treatments are to lose weight, increase activity and exercise that is low impact such as water aerobics or swimming and use of hot and cold therapy.Turmeric intake reduces pain and inflammation of the joints. Massage therapy is also helpful. If you suffer from joint pain please add to the survey. This would help in finding out prevailing of arthritis in our community and may help to find better diagnoses and treatment. Of course personal identity will not be revealed or compromised. Survey to include name, age, gender, city, symptoms of pain, swelling, limitation of joint movements, duration of symptoms, treatment used such as Advil naproxen , steroids, surgery.


Asthma is a chronic disease involving the airways such as bronchial tubes in the lungs.

In asthma these tubes get inflamed. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness. Occurrence of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma symptoms only when exercising.This is called exercise-induced bronchoconstriction (EIB), or exercise-induced asthma (EIA).

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.

 Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

A biologic is a medication made from the cells of a living organism, such as bacteria or mice, which is then modified to target specific molecules in humans. For asthma, the targets are antibodies, inflammatory molecules, or cell receptors. By targeting these molecules, biologics work to disrupt the pathways that lead to inflammation that causes asthma symptoms.

Currently there are five approved biologics for asthma – Omalizumab, Mepolizumab, Reslizumab, Benralizumab, and Dupilumab  Treatment is given by injection for a period of four months.

Other treatment includes change in the environments, stop smoking, avoiding dust or pollens, Use of Bronchodilators as inhalation therapy and Steroids for short-term use.

Cardiovascular disease

When to see a doctor

If you suspect you’re having a heart attack, immediately call your local emergency number. If you don’t have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort.

If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity — talk to your doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries.

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness. COPD may be mild, Moderate or Severe.

Treatments include many different drugs, special exercises, oxygen therapy, surgery, and complementary therapies.

Medications for COPD can help improve your lung capacity, ease inflammation, relax muscles in your airways, and improve your breathing. They include:

Bronchodilators that you breathe in through an inhaler. These come in short- and long-acting forms. Some stop the muscles in your airways from tightening up (anticholinergics). Others relax muscles that are already tight (beta agonists).

Anti-inflammatory meds or corticosteroids (or steroids) are often inhaled COPD drugs. But if your symptoms are getting worse, you may take pills for a short time.

Antibiotics to fight infections that cause symptom flare-ups.

Vaccinations against the flu or pneumonia.

Roflumilast (Daliresp). It’s the first of a new class of COPD drugs called phosphodiesterase-4 inhibitors that ease flares for people at the severe stage.

Cystic fibrosis

Cystic Fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body.

Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. 

Symptoms vary and can include

  • Cough
  • Repeated lung infections
  • Inability to gain weight
  • Fatty stools.


Treatments may ease symptoms and reduce complications.

Newborn screening helps with early diagnosis.

Genetic (or carrier) testing not only plays a key role in the diagnosis of cystic fibrosis, but testing also allows parents to find out what their chances of having a child with CF are to help inform important family planning decisions. A person may wish to get a genetic carrier test for CF or a sweat test if they have symptoms of CF, based on their doctor’s recommendations.


Cardiovascular disease includes conditions that affect the structures or function of your heart, such as:

  1. Coronary artery disease (narrowing of the arteries)
  2. Heart attack.
  3. Abnormal heart rhythms, or arrhythmias.
  4. Heart failure.
  5. Heart valve disease.
  6. Congenital heart disease.
  7. Heart muscle disease (cardiomyopathy)

Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.

When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.


If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any coronary artery disease symptoms. As plaque continues to build up in your coronary arteries, however, you may develop coronary artery disease signs and symptoms, including:

  • Chest pain (angina).You may feel pressure or tightness in your chest, as if someone were standing on your chest. This pain, referred to as angina, usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress.

The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the neck, arm or back.

  • Shortness of breath.If your heart can’t pump enough blood to meet your body’s needs, you may develop shortness of breath or extreme fatigue with exertion.
  • Heart attack.A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating.

Women are somewhat more likely than men are to experience less typical signs and symptoms of a heart attack, such as neck or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.

Dementia and Alzheimer’s disease

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss and judgment is an example. Symptoms include forgetfulness, limited social skills, and thinking abilities so impaired that it interferes with daily functioning.
Alzheimer’s is the most common type of dementia.
Alzheimer’s disease typically progresses slowly in three general stages — mild (early stage), moderate (middle stage), and severe (late stage). Since Alzheimer’s affects people in different ways, the timing and severity of dementia symptoms varies as each person progresses through the stages of Alzheimer’s differently.
Different types of dementia are associated with particular types of brain cell damage in particular regions of the brain. For example, in Alzheimer’s disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other. The brain region called the hippocampus is the center of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That’s why memory loss is often one of the earliest symptoms of Alzheimer’s.
  • Depression
  • Medication side effects
  • Excess use of alcohol
  • Thyroid problems
  • Vitamin deficiencies

Moderate Alzheimer’s is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of care.

  • Trouble controlling bladder and bowels in some individuals
  • Changes in sleep patterns, such as sleeping during the day and becoming restless at night
  • An increased risk of wandering and becoming lost
  • Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding

Medications and therapies may help manage symptoms. Some causes are reversible.

The U.S. Food and Drug Administration (FDA) has approved two types of medications — cholinesterase inhibitors (Aricept, Exelon, Razadyne) and memantine (Namenda) — to treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer’s disease.

As Alzheimer’s progresses, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While current medications cannot stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain’s nerve cells. Doctors sometimes prescribe both types of medications together.
Three cholinesterase inhibitors are commonly prescribed:

  • Donepezil (Aricept) is approved to treat all stages of Alzheimer’s.
  • Rivastigmine (Exelon) is approved to treat mild to moderate Alzheimer’s.
  • Galantamine (Razadyne) is approved to treat mild to moderate Alzheimer’s.


Depression is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Types of depression

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
Postpartum depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression).
The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.
Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”
Depression is usually treated with medications, psychotherapy, or a combination of the two.
Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects.
Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness., usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose.
Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression.  If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:
Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS).

High blood pressure

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease or stroke There are times when high blood pressure is considered an emergency and requires urgent medical attention. … Seek emergency care if your blood pressure reading is 180/110 or higher and you have any of the following symptoms, which may be signs of organ damage: Chest pain. Shortness of breath.
There are several types of drugs used to treat high blood pressure, including: Angiotensin-converting enzyme (ACE) inhibitors. Angiotensin II receptor blockers (ARBs) Diuretics.


Physical exercise Aerobic activity for 20-30 minutes 5 days a week improves cardiovascular health. If injured, pursuing an activity that avoids the injured muscle group or joint can help maintain physical function while recovering.
Stress management
pursuing an enjoyable activity or verbalizing frustration to reduce stress and improve mental health.
Quitting smoking
quitting smoking tobacco.
Home blood pressure monitor
regular monitoring of blood pressure can help diagnose high blood pressure.
Low sodium diet
A diet that restricts salt (sodium chloride) and other forms of sodium to no more than 2,000 mg per day

ACE inhibitor

Relaxes blood vessels, lowers blood pressure and prevents diabetes-related kidney damage.
Lisinopril can reduce high blood pressure and treat heart failure. It can reduce the risk of death after a heart attack and Benazepril can reduce high blood pressure.


Increases urine production to get rid of excess salt and water

Beta blocker

Slows heart rate and decreases blood pressure. When taken in eye-drop form, it reduces eye pressure.

Atenolol is used with or without other medications to treat high blood pressure (hypertension). … This medication is also used to treat chest pain (angina) and to improve survival after a heart attack.Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).  Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure).  Metoprolol is also used to lower your risk of death

Nifedipine and Irbesartan can reduce blood pressure, reduce chest pain. Later can treat diabetic nephropathy

Calcium channel blocker

Relaxes blood vessels.
Amlodipine and Nifedipine can treat high blood pressure and angina

Widens blood vessels.
Hydralazine can treat high blood pressure.



A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. 

Warning Signs of Stroke

  1. Sudden numbness or weakness in the face, arm or leg (especially on one side of the body).
  2. Sudden confusion or trouble speaking or understanding speech.
  3. Sudden vision problems in one or both eyes.
  4. Sudden difficulty walking or dizziness, loss of balance or problems with coordination.
  5. Severe headache with no known cause.

Types of Stroke

Ischemic Stroke (Clots) Occurs when a blood vessel supplying blood to the brain is obstructed.

Hemorrhagic Stroke (Bleeds) Occurs when a weakened blood vessel ruptures. Hemorrhagic stroke

Hemorrhagic strokes are caused by blood leaking into the brain, so treatment focuses on controlling the bleeding and reducing the pressure on the brain.

Treatment can begin with drugs given to reduce the pressure in the brain, control overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.

If an individual is taking blood-thinning anticoagulants or an antiplatelet medication like warfarin or clopidogrel, they can be given drugs to counter the effects of the medication or blood transfusions to make up for blood loss.

Surgery can be used to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes. Surgeons can place small clamps at the base of aneurysms or fill them with detachable coils to stop blood flow and prevent rupture.

If the hemorrhage is caused by arteriovenous malformations (AVMs), surgery can also be used to remove them if they are not too big and not too deep in the brain. AVMs are tangled connections between arteries and veins that are weaker and burst more easily than other normal blood vessels.

TIA (Transient Ischemic Attack) Called a “mini stroke,” it’s caused by a serious temporary clot. …

Cryptogenic stroke (CS) is defined as cerebral ischemia of obscure or unknown origin. The cause of CS remains undetermined because the event is transitory or reversible, investigations did not look for all possible causes, or because some causes truly remain unknown. One third of the ischemic strokes is cryptogenic.

Use FAST to remember and recognize the following signs and symptoms of stroke:

  • F: Face drooping. Ask the person to smile, and see if one side is drooping.
  • A: Arm weakness. Ask the person to raise both arms.
  • S: Speech difficulty.
  • T: Time to call Emergency Number 

The Best Foods to Prevent Stroke

  • Nuts. In one study, adding an ounce of nuts per day seemed to cut the risk of stroke in half.
  • Greens.
  • Chocolate.
  • Citrus fruits.
  • Whole grains.
  • Garlic.
  • Tomatoes.
  • Coffee and green tea.

Ischemic strokes are most often caused by atherosclerosis, or hardening of the arteries, and carry the same risk factors as heart attacks (myocardial infarction, coronary artery disease) and peripheral vascular disease. These include high blood pressure, high cholesterol, diabetes, and smoking.

Aspirin prevents blood clots from forming in the arteries. It can help certain people lower their risk of a heart attack or stroke. But taking aspirin isn’t right for everyone, because it can cause serious bleeding. You and your doctor can decide if aspirin is a good choice for you.


Strokes are life-changing events that can affect a person both physically and emotionally. After a stroke, successful recovery will often involve specific therapies and support, such as:

Speech therapy: This helps with any problems producing or understanding speech. Practice, relaxation, and changing communication style can all help.

Physical therapy: This can help a person relearn movement and co-ordination. It is important to stay active, even if it is difficult at first.

Occupational therapy: This is used to help a person to improve their ability to carry out routine daily activities, such as bathing, cooking, dressing, eating, reading, and writing.

Support groups: These help with common mental health problems such as depression that can occur after a stroke. Many find it useful to share common experiences and exchange information.

Support from friends and family: The people closest to a person should offer practical support and comfort after a stroke. Letting friends and family know what can be done to help is very important.

Rehabilitation is an important and ongoing part of treatment. With the right assistance and the support of loved ones, rehabilitation to a normal quality of life is possible, depending on the severity of the stroke.


The best way to prevent a stroke is to address the underlying causes. This is best achieved through lifestyle changes, including:

  • Eating a healthy diet
  • Maintaining a healthy weight
  • Exercising regularly
  • Not smoking tobacco
  • Controlling Diabetes



Cancer is a complex disease that may develop when cells in the body begin to grow and spread out of control. When division of cells is uncontrolled it may result in death. Factors that may cause these cells to go out of control is use of tobacco, chemicals exposure and exposure to radiation or infectious organisms. The internal causes are inherited mutations, changing hormones and immune conditions including mutations that occur from metabolism. Cancer cells continue to grow and divide and are different than normal cells. Cancers cells may spread from the original site to distant organs causing meta-stasis. Cancer cells develop because of damage to DNA that is part of each and every cell in the human body.
Common types of cancers
Skin cancer, there are several kinds of skin cancer including melanoma originating from the pigment cells and basal cell or squamous cell carcinoma. Mostly this occurs when skin is exposed to sun.
Breast cancer is most frequent cancer in women. It can occur in men and women.
Prostate cancer forms in the prostate gland and usually occurs in older men causing urinary symptoms.
Colon cancer forms in any part of the colon. Most common is adenocarcinoma. Screening for colon cancer by checking stools for blood and colonoscopy is recommended.
Rectal cancer forms in the tissue of the rectum causing constipation, incontinence of stool and blood in the stools.
Bladder cancer forms transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma begins in the cells make the release of mucous and other fluids.
Lung cancer forms in the tissue of lungs or bronchioles. Cigarettes smoking is the most important risk factor associated with lung cancer.
Kidney cancer forms in the tissue of the kidneys. It is in the form of renal cell carcinoma or renal pelvis carcinoma it also comes as Wilm’s tumor usually seen in children under the age of five.
Leukemia is the cancer of the blood forming tissue, may start in the bone marrow and causes large number of blood cells to be produced.
Non-Hodgkin’s lymphoma is group of cancers of immune system. Usually accompanied with large lymph nodes, fever and weight loss. Night sweating may be noticed. Different types are B cell and T cell cancer including Bucket’s lymphoma.
Pancreatic cancer found in the tissue of pancreas and is difficult to diagnose in early stages.
Thyroid cancer appears in the thyroid gland in the neck area it may increase heart rate, body temperature and weight.
Early screening and regular doctor visit for routine examination are recommended.
Intake of a healthy diet including antioxidants with colored vegetables and fruits.
Have regular activity and exercise.
Avoid carcinogens such as cigarette smoking.

Please submit this form if anyone in your family had cancer


    Diabetes is a disease in which blood sugar levels are too high. Glucose comes from the foods we eat. Insulin is a hormone that helps the glucose gets into cells to give energy.

    Diabetes Type 1:  Pancreas does not make insulin.

    Diabetes Type 2:  A chronic condition that affects the way the body processes blood sugar (glucose).


    Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. … Of those with prediabetes, 90% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.


    A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.


    Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy.

    Doctors most often test for it between 24 and 28 weeks of pregnancy.

    Gestational diabetes me lead to problems in pregnancy including large size baby causing difficulty in birth and resulting in C-section delivery of the baby.


    It may result in high blood pressure with proteins in the urine and swelling of fingers and toes resulting in pre-eclampsia. That results in higher maternal and fetal mortality. It may also cause low blood sugars

    With the gestational diabetes woman should eat healthy foods and see a dietitian.

    Exercise regularly at least 30 minutes of moderate intensity physical activity at least five days a week.

    Monitor blood sugars regularly take insulin if necessary.

    Common warnings signs of diabetes include:

    • Increased thirst
    • Increased hunger
    • Dry mouth
    • Frequent urination or urine infections
    • Unexplained weight loss
    • Fatigue
    • Blurred vision
    • Headaches
    • Skin infections with delayed healing


    Boost your intake of vegetables and fresh fruit

    Eat more low-fat dairy products and beans

    Choose whole grains diet

    Eat fish, poultry, and lean meat instead of fatty red meat or processed meat


    Diabetes: Education and Support

    Diabetes Self-Management Education and Support (DSMES) services help people with diabetes learn how to take the best care of themselves. Ask us or your doctor for a referral to DSMES services to help you manage your diabetes.


    How will DSMES help me?

    When you learn that you have diabetes, your first question might be, “What can I eat?” DSMES will answer this question and many others. We will teach you how to stay healthy and how to manage your diabetes.


    DSMES services will help you:

    • Be active.
    • Check your blood sugar(glucose).
    • Cope with the emotional side of diabetes.
    • Eat healthy.
    • Make better decisions about your diabetes.
    • Reduce your risk of other health complications.
    • Solve problems.
    • Take your medicine.
    • Understand how to take care of yourself and learn the skills to:
    • Work with your health care team to get the support you need.

    Epilepsy and seizure

    Epilepsy and Seizures: A seizure is a single occurrence, whereas epilepsy is a neurological condition characterized by two or more unprovoked seizures.

    seizure triggers. Triggers are situations that can bring on a seizure in some people with epilepsy. Some people’s seizures are brought on by certain situations. Triggers can differ from person to person, but common triggers include tiredness and lack of sleep, stress, alcohol, and not taking medication. Seizures are not always related to epilepsy. They can be a symptom of a disruption of brain function, such as from a high fever, a head injury or lack of oxygen.

    Epilepsy may occur as a result of a genetic disorder or an acquired brain injury, such as a trauma or stroke. During a seizure, a person experiences abnormal behavior, symptoms, and sensations, sometimes including loss of consciousness. There are few symptoms between seizures. Epilepsy is usually treated by medications and in some cases by surgery, devices, or dietary changes.


    Obesity According to a list of the world’s “fattest countries” published on Forbes, Pakistan is ranked 165 (out of 194 countries) in terms of its overweight population, with 22.2% of individuals over the age of 15 crossing the threshold of obesity.

    50% of the population in Pakistan is obese

    Body mass index (BMI) is a measure used to determine childhood overweight and obesity. Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex.

    BMI is calculated by dividing a person’s weight in kilograms by the square of height in meters. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. A child’s weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults. This is because children’s body composition varies as they age and varies between boys and girls. Therefore, BMI levels among children and teens need to be expressed relative to other children of the same age and sex.

    For example, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m2. This would place the boy in the 95th percentile for BMI, and he would be considered as obese. This means that the child’s BMI is greater than the BMI of 95% of 10-year-old boys in the reference population.

    The CDC Growth Charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States.

    BMI-for-age weight status categories and the corresponding percentiles were based on expert committee recommendations and are shown in the following table.

    BMI-for-age weight status categories and the corresponding percentiles
    Weight Status Category Percentile Range
    Underweight Less than the 5th percentile
    Normal or Healthy Weight 5th percentile to less than the 85th percentile
    Overweight 85th to less than the 95th percentile
    Obese 95th percentile or greater

    BMI does not measure body fat directly, but research has shown that BMI is correlated with more direct measures of body fat, such as skinfold thickness measurements, bioelectrical impedance, densitometry (underwater weighing), dual energy x-ray absorptiometry (DXA) and other methods 1,2,3. BMI can be considered an alternative to direct measures of body fat. A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks.

    Adult Body Mass Index (BMI)

    Body Mass Index (BMI) is a person’s weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness.

    To calculate BMI, see the Adult BMI Calculator or determine BMI by finding your height and weight in this BMI Index Chart

    • If your BMI is less than 18.5, it falls within the underweight range.
    • If your BMI is 18.5 to <25, it falls within the normal.
    • If your BMI is 25.0 to <30, it falls within the overweight range.
    • If your BMI is 30.0 or higher, it falls within the obese range.

    Obesity is frequently subdivided into categories:

    • Class 1: BMI of 30 to < 35
    • Class 2: BMI of 35 to < 40
    • Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity.

    Note: At an individual level, BMI can be used as a screening tool but is not diagnostic of the body fatness or the health of an individual. A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks. If you have questions about your BMI, talk with your health care provider.

    See the following table for an example.

    Height Weight Range BMI Considered
    5 9 124 lbs or less Below 18.5 Underweight
    125 lbs to 168 lbs 18.5 to 24.9 Healthy weight
    169 lbs to 202 lbs 25.0 to 29.9 Overweight
    203 lbs or more 30 or higher Obese
    271 lbs or more 40 or higher Class 3 Obese


    Preventing Obesity

    There is no single or simple solution to the obesity epidemic. It’s a complex problem and there has to be a multifaceted approach. Policy makers, state and local organizations, business and community leaders, school, childcare and healthcare professionals, and individuals must work together to create an environment that supports a healthy lifestyle. There are several ways state and local organizations can create a supportive environment to promote healthy living behaviors that prevent obesity.

    Physical Activity

    The evidence is clear—physical activity fosters normal growth and development, can reduce the risk of various chronic diseases, and can make people feel better, function better, and sleep better. Some health benefits start immediately after activity, and even short bouts of physical activity are beneficial.

    Preschool Children Preschool-aged children (ages 3 through 5 years) should be physically active throughout the day to enhance growth and development.

    Adult caregivers of preschool-aged children should encourage active play that includes a variety of activity types.

    Key Guidelines for Children and Adolescents

    It is important to provide young people opportunities and encouragement to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety.

    • Children and adolescents ages 6 through 17 years should do 60 minutes (1 hour) or more of moderate-to-vigorous physical activity daily:
    • Aerobic: Most of the 60 minutes or more per day should be either moderate- or vigorous intensity
    • Aerobic physical activity and should include vigorous-intensity physical activity on at least 3 days a week.
    • Muscle-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days a week.
    • Bone-strengthening: As part of their 60 minutes or more of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days a week. 

    Key Guidelines for Adults

    Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.

    • For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week.
    • Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
    • Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.


    Osteoporosis, which literally means porous bone, is a disease in which the density and quality of bone are reduced. As bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs silently and progressively.

    There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you may have signs and symptoms that include: Back pain, caused by a fractured or collapsed vertebra.  Loss of height over time.

    The body constantly absorbs and replaces bone tissue. With osteoporosis, new bone creation doesn’t keep up with old bone removal.

    Treatment includes medications, healthy diet, and weight-bearing exercise to help prevent bone loss or strengthen already weak bones.

    Common medications used for osteoporosis treatment

    • Alendronate (Fosamax)
    • Risedronate (Actonel)
    • Ibandronate (Boniva)
    • Zoledronic acid (Reclast)
    • raloxifene (Evista)

    Good sources of calcium include

    • Milk, cheese and other dairy foods.
    • Green leafy vegetables, such as broccoli, cabbage and okra, but not spinach.
    • Soya beans.
    • Soya drinks with added calcium.
    • Bread and anything made with fortified flour.
    • Fish where you eat the bones, such as sardines and pilchards.

    Although osteoporosis can strike at any age, it is most common among older people, especially older women. Men also have this disease. White and Asian women are most likely to have osteoporosis, by age 65, men and women are losing bone at the same rate.

    Other women at great risk include those who:

    • Have a family history of broken bones or osteoporosis
    • Have broken a bone after age 50
    • Had surgery to remove their ovaries before their periods stopped
    • Had early menopause
    • Have not gotten enough calcium and/or vitamin D throughout their lives
    • Had extended bed rest or were physically inactive
    • Smoke (smokers may absorb less calcium from their diets)
    • Take certain medications, including medicines for arthritis and asthma and some cancer drugs
    • Used certain medicines for a long time
    • Have a small body frame (survey)

    Many chronic diseases have genetic components which increases disease risk in certain people. Environment and exposure to polluted air, lifestyle choices including diet and smoking may affect the outcome of chronic disease.

    Chronic diseases